Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, July 14, 2010

I Wonder Is There a Lunatic Out There Who Would Take This On?

Health and Ageing: Employment Opportunity N.N. 10485856

Department of Health and Ageing Closing date: Monday, 26 July 2010

Executive Division

Job Title: Chief Information and Knowledge Officer

Job Type: Ongoing, Full-time

Location: Canberra | ACT

Classification: Senior Executive Service Band 3

Job Description

Duties

The Department of Health and Ageing is seeking to appoint a Chief Information and Knowledge Officer to assume responsibility for the ongoing transformation of its technology and information capabilities as it proceeds to implement the Government’s recently announced health reform agenda.

Reporting to the Secretary of the Department, and as a key member of the Senior Executive Group, the appointee will have leadership responsibility for information and knowledge management across the portfolio. This will include an organisation-wide focus on data, performance and information to improve health outcomes and to support advances in the development of e-health, including recent Australian Government investment in a personally controlled electronic health record system. The successful candidate will be expected to work closely with a wide range of internal and external stakeholders while developing and coordinating systemic approaches to harnessing information, knowledge, records management and intelligence.

The appointee will have a comprehensive understanding of information and knowledge management and integration processes, preferably from a health perspective, including an understanding of the importance of electronic health solutions. He/she will also have a strong track record in leading and delivering major change programs in large, complex and politically sensitive environments. High level strategic policy advisory skills, outstanding stakeholder management capabilities and the personal capacity to make a major contribution at a strategic level within the portfolio will be required.

The full advertisement is here:

http://www.apsjobs.gov.au/SearchedNoticesView.aspx?Notices=10485856%3A1&mn=SESSearch

The good things about this is that it is at the right level for what needs to be done – reporting directly to the Secretary of the Department and that there is probably enough money to get started (the $446 M over 2 years).

The bad is that it is probably not paid enough – the level goes to about $250,000 p.a. or so – and that there is only 2 years to show any outcomes and that there is currently not a capable delivery organisation to lead in place (meaning it will need to be built).

I have to say taking this on without having some major understandings about governance, discretion and authority – as well as clarity about just where NEHTA fits would be courageous.

My preferred outcome is that this position would actually lead the organisation contemplated in the Deloittes National E-Health Strategy.(See page 66)

Impact on NEHTA

The establishment of a national E-Health Entity will directly impact the role of NEHTA. NEHTA, a collaborative enterprise owned by Australian, State and Territory Governments, was established to identify and jointly develop foundations for E-Health such as the definition of an agreed set of key national E-Health standards and specifications. This constitutes a subset of the functions proposed for the E-Health Entity. NEHTA’s organisational charter expires in June 2009 and hence there is an increasingly urgent need to address the future of the organisation.

In light of the proposal for the establishment of a national E-Health Entity with a significantly broader set of accountabilities and functions than NEHTA in its current form, there are three implementation options that have been considered:

NEHTA to form the basis of the new E-Health Entity with a broader remit

Establish a new legal E-Health Entity and integrate NEHTA’s current execution functions into its structure

Establish a new legal E-Health Entity and allow NEHTA to operate as a separate organisation with accountability for the delivery of core E-Health foundations.

The first option is for NEHTA to form the organisational basis of the new E-Health Entity. This would require the existing NEHTA organisation to extend its accountabilities and functions to allow effective governance of the national E-Health Strategy and the execution of the national components of the three strategic work streams. This option would necessitate changes to NEHTA’s constitutional basis to extend the range of organisational responsibilities and to end the transitional nature of the authority. It would also require changes to the organisation’s brand and operating model.

The advantage of this approach is that the existing NEHTA organisation including legal structure, resources, capabilities, funding and governance arrangements, could be relatively quickly leveraged to support the establishment of the new E-Health Entity. One disadvantage is the extent of work required to restructure, refocus and reskill the organisation. The other is the need to overcome the historic and reasonably widespread perception in parts of the health sector that NEHTA’s progress to date has been too slow and not inclusive enough of the care provider community.

The second option is to establish a new legal E-Health Entity that would integrate NEHTA’s existing execution functions into its structure. The advantage of this option is the establishment of a new national E-Health Entity with a clear set of accountabilities and which is unencumbered by history. The key disadvantage is that the structure and constitutional and legal basis for this organisation must be designed and created from scratch which is likely to be a lengthy exercise and therefore could delay meaningful progress towards national E-Health outcomes.

The third option is to establish a new legal E-Health Entity and allow NEHTA to operate as a separate organisation with accountability for design and execution of national E-Health foundations. In this option, NEHTA would report in to, and seek strategic direction and funding from, the E-Health Entity. This option will minimise impacts to the existing NEHTA work program, but will also create delays associated with the establishment of the new entity. It will also create the significant potential for overlap, duplication and poor coordination between the two organisations, ultimately risking the coordinated delivery of national E-Health outcomes.

----- End Extract.

Option 1 is the go in my view!

Unless all this is sorted this job is a real ‘poison chalice’!

I note in passing that an earlier e-Health head has apparently moved on to the AHIW.

Lisa McGlynn

Australian Institute of Health and Welfare

Bruce | ACT

Senior Executive Service Band 1

No one seems to stay very long in e-Health in DoHA. It might just be that herding cats is just too hard!

David.

The USA Shows How Leadership Really Matters in e-Health.

This appeared overnight – and I would suggest is the most important step for e-Health taken anywhere in the world since the release in the UK of its ‘Information for Health’ Strategy about 8 years ago.

What is described here is the outcome that can be worked towards when some real smarts, some real leadership and some real money are used to address an obvious problem.

Australia compares so poorly in all three areas right now it is really very sad I believe.

The “Meaningful Use” Regulation for Electronic Health Records

Posted by NEJM • July 13th, 2010 • Printer-friendly

David Blumenthal, M.D., M.P.P., and Marilyn Tavenner, R.N., M.H.A.

The widespread use of electronic health records (EHRs) in the United States is inevitable. EHRs will improve caregivers’ decisions and patients’ outcomes. Once patients experience the benefits of this technology, they will demand nothing less from their providers. Hundreds of thousands of physicians have already seen these benefits in their clinical practice.

But inevitability does not mean easy transition. We have years of professional agreement and bipartisan consensus regarding the potential value of EHRs. Yet we have not moved significantly to extend the availability of EHRs from a few large institutions to the smaller clinics and practices where most Americans receive their health care.

Last year, Congress and the Obama administration provided the health care community with a transformational opportunity to break through the barriers to progress. The Health Information Technology for Economic and Clinical Health Act (HITECH) authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHRs privately and securely to achieve specified improvements in care delivery.

Through HITECH, the federal government will commit unprecedented resources to supporting the adoption and use of EHRs. It will make available incentive payments totaling up to $27 billion over 10 years, or as much as $44,000 (through Medicare) and $63,750 (through Medicaid) per clinician. This funding will provide important support to achieve liftoff for the creation of a nationwide system of EHRs.

Equally important, HITECH’s goal is not adoption alone but “meaningful use” of EHRs — that is, their use by providers to achieve significant improvements in care. The legislation ties payments specifically to the achievement of advances in health care processes and outcomes.

HITECH calls on the secretary of health and human services to develop specific “meaningful use” objectives. With the Centers for Medicare and Medicaid Services (CMS) in the lead, the Department of Health and Human Services (DHHS) has used an inclusive and open process to develop these criteria, providing an extensive opportunity for public and professional input. The department published proposed meaningful use requirements on January 16, 2010. The proposal prompted some 2000 comments. This week, the DHHS is releasing a final regulation for the first 2 years (2011 and 2012) of this multiyear incentive program. Subsequent rules will govern later phases.

The full article is here:

http://healthcarereform.nejm.org/?p=3732&query=OF

A .pdf can be downloaded from the bottom of the article. This is worth doing to read the contents of just what is required to receive the $27 Billion in incentive payments.

The Journal has also published an amusing story on one doctor’s trip to the EHR!

Finding My Way to Electronic Health Records

Posted by NEJM • July 13th, 2010 • Printer-friendly

Regina Benjamin, M.D., M.B.A.

The recent oil spill off the Gulf Coast may prove to be one of the great environmental challenges of our lifetime. It is yet another devastating blow to the Gulf region, a place I call home. My heart goes out to the people there who are concerned about how this latest disaster will affect their livelihood and their health. Though the full effects of the spill remain to be seen, already the health needs of Gulf Coast inhabitants are increasing during this time of crisis. Physicians in the area will need to adapt and find innovative ways to efficiently deliver health care for an already underserved population. I recall my experiences as a physician during the crises of Hurricanes Georges and Katrina and try to remember how I adapted.

Full tale here:

http://healthcarereform.nejm.org/?p=3736&query=OF

For another take on all this it is worth reading John Halamka’s blog.

http://geekdoctor.blogspot.com/2010/07/meaningful-use-and-standards-are.html

Tuesday, July 13, 2010

Meaningful Use and the Standards are Finalized

Today at 10am, CMS and ONC released the final rules that will guide electronic health record rollouts for the next 5 years. Key resources include:

New England Journal of Medicine overview. The table provides a detailed list of final meaningful use requirements.

Federal Register publication of the Meaningful Use regulation

Federal Register publication of the Standards regulation

.....

Overall, a very good day for ONC, HHS and stakeholders. The final rule means Meaningful Use will be achievable by many. The Standards and the process to certify their use are sufficiently specific. I'm impressed.

John Halamka

Read and take heart. Good things are possible I believe but lacking the leadership and governance frameworks I am not at all confident they will come to pass.

David.

Tuesday, July 13, 2010

Let’s Get Real With This Silly Patient Controlled EHR Story.

I came upon this great opinion piece the other day.

http://www.fierceemr.com/story/tale-two-phr-models/2010-07-08

Portals see high usage, while untethered PHRs may compromise safety

July 8, 2010 — 1:29pm ET | By Neil Versel

Editor’s Corner

Whenever I get a pitch about personal health records, I immediately ask if the publicist has any evidence that people are using the product in question. I rarely get a response because I know that in most cases, there is no such evidence. The lone exception is a PHR that's "tethered" to a large health system's EMR.

Some such evidence surfaced this week, when the University of Texas M.D. Anderson Cancer Center in Houston reported that 57 percent of patients and a surprisingly strong 40 percent of outside referring physicians are using the center's year-old web portal. And using it often. According to Healthcare IT News, patients have been logging into the portal an average of 3.3 times a week--that's once every other day--and referring physicians are accessing M.D. Anderson patient records 2.8 times weekly.

Not surprisingly, M.D. Anderson's primary EMR vendor is Epic Systems. The company's myChart PHR--called myMDAnderson at the Houston institution--is an integral part of the Epic Care EMR for so many of Epic's customers. The Cleveland Clinic, Kaiser Permanente, NorthShore University HealthSystem in Illinois, the University of Texas Medical Branch and Dean Health Care are among those that have had success with myChart. Partners HealthCare System in Boston, which built its own EMR, also has seen wide acceptance of patient portal.

Why does this model work? Because the EMR automatically populates each patient's PHR, saving people from having to enter all of their own data. Think of personal financial software before online banking became widespread. Who was going to sit down and type the entire contents of a handwritten check register into a Quicken screen? Virtually nobody. But when users gained the ability to download bank statements directly into the software, sales took off.

That's why I am not surprised by the findings in a newly published paper in the Journal of the American Medical Informatics Association. The author, Dr. Donald Simborg, co-founder and board member of Health Level Seven International and a founding member of the American College of Medical Informatics, argues that "untethered" PHRs create "a form of unhealthy consumer populism" by disrupting physician workflow.

Read all the gruesome details here:

http://www.fierceemr.com/story/tale-two-phr-models/2010-07-08

Here is the link to the paper being discussed along with the abstract.

http://jamia.bmj.com/content/17/4/370.abstract

JAMIA 2010;17:370-372 doi:10.1136/jamia.2010.003392

  • Viewpoint paper
Consumer empowerment versus consumer populism in healthcare IT

  1. Donald W Simborg
  1. Correspondence to Dr Donald W Simborg, 407 Old Downieville Hwy, Nevada City, CA 95959, USA; dsimborg@sbcglobal.net
  • Received 19 January 2010
  • Accepted 30 April 2010

Abstract

Institutions, providers, and informaticians now encourage healthcare consumers to take greater control of their own healthcare needs through improved health and wellness activities, internet-based education and support groups, and personal health records. The author believes that “untethering” all of these activities from provider-based record systems has introduced a form of unhealthy consumer populism. Conversely, integrating these activities in a coordinated manner can sustain both consumer empowerment and consumer well-being.

----- End Abstract.

The one line summary is pretty simple – unless you have links between professional data sources and a patient held record they won’t be used and if they are they are likely to be potentially dangerous.

The only way the crazy plans from the Department of Health and NEHTA can work is if GPs, specialists, lab information providers and the like contribute information to the patient held record.

If you think this is going to happen without very substantial incentives and assistance being put in place – for which at present, as far as we know, there is no budget, you are dreaming!

This is the second shoe to fall in my view. First we know the evidence for the value and effectiveness of PHRs vs EMRs is absent and second we now know the apparent plans from DoHA will do nothing to remedy this issue.

Of course we have also yet to hear just how the issue of the ‘digital divide’ is to be addressed – i.e. how is a PHR going to help those without regular internet access? (This is a good fraction of the target audience as I understand it.)

All this needs to go back to a fundamental and open-minded review. Right now what we know suggests some pretty bad mistakes are being planned.

Maybe after the election!

David.

Monday, July 12, 2010

We Are Heading Towards A Major Fiasco In Australian E-Health. Total Fragmentation and Dysfunctional Unplanned Directions.

I was prompted to start thinking about the messy direction we seem to be hurtling down in e-Health by a couple of things that have appeared over the last few weeks

First we have had the Telstra / RACGP announcement.

Telstra, GPs in e-health agreement

Telstra plays a card in the e-health game, signs MOU with the Royal Australian College of General Practitioners

  • AAP (Computerworld)
  • 09 July, 2010 07:49

The nation's GPs and Telstra have reached an agreement on the roll-out of "critical first step" e-health reforms.

The Royal Australian College of General Practitioners (RACGP) has signed a memorandum of understanding with the telco giant, outlining a range of hi-tech services to be brought online from next year.

The first would allow the nation's 17,200 GPs to access health care applications, diagnostic tools and an array of other clinical and administrative software programs using a "single log-on" web service.

"A web-hosted service will make GPs lives easier (allowing them to) access applications from anywhere - from their practises, homes, hospitals or aged care facilities," RACGP president Dr Chris Mitchell said in a statement on Thursday.

"GPs are busy and the implementation of a national e-health strategy might seem daunting, however ... this collaboration will make it easy for general practise to take advantage of the new technology we now have available."

The web service, to be operating from July next year, would also end the current need for clinics to each purchase their own copy of the software used by their GPs.

More here:

http://www.computerworld.com.au/article/352600/telstra_gps_e-health_agreement/?eid=-255

The same issue is also covered here:

Telstra to provide e-health cloud to GPs

By Suzanne Tindal, ZDNet.com.au on July 8th, 2010

The Royal Australian College of General Practitioners and Telstra have this week signed a memorandum of understanding that will hopefully see the telco provide software as a service to the college's members.

Over the next few months, the college will hold working groups with members and stakeholders to decide on specialist medical systems it would like Telstra to provide via the cloud.

These could include clinical software programs, decision support tools for diagnosis and management, care plans, referral tools, e-prescribing tools, as well as a range of online training and other administrative and clinical services.

Once systems have been decided on, Telstra will provide access to them using a T-Suite-backed single sign-on platform, according to Dr Chris Mitchell, president of the Royal Australian College of General Practitioners. The College has 17,200 GP members.

"GPs are busy and the implementation of a national e-health strategy might seem daunting. However, staying up-to-date and making sense of the latest technology is important," Mitchell said. "A web-hosted service will make GPs' lives easier. A web-based solution means GPs can access applications from anywhere; from their practices, homes, hospitals or aged care facilities."

No money has changed hands and no contracts have been signed, with Mitchell saying that the arrangement was very much at the beginning of its journey.

Mitchell thought that some of the general applications already on T-Suite could now benefit the college's members, but hoped that more medical-specific software would make its way onto the Telstra cloud platform within the next three to six months. Certainly he hoped to see software made available before July next year.

"We're really keen to get started on this very quickly," he said.

Telstra sounded more cautious. Telstra spokesperson Rod Bruem said that existing desktop software apps would move across to the platform by mid next year with beta testing to be carried out later this year.

More here:

http://www.zdnet.com.au/telstra-to-provide-e-health-cloud-to-gps-339304407.htm?omnRef=NULL

When examined a little more closely what this announcement is really all about is moving the GPs who sign up to an application suite, delivered over broadband, using Software as a Service techniques.

The software available at present from this service includes anti-virus, financial, HR management and CRM applications. According to the Telstra website the actual GP or clinical software is exactly zero, as far as I can tell.

See here:

http://www.telstrabusiness.com/business/portal/online/site/productsservices/businesssoftware.11003

I just note in passing the recent articles on cloud computing security. For Health Information we really want near total security.

http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2010/07/06/urnidgns852573C40069388000257758003E5DC7.DTL

Secrecy of cloud computing providers raises IT security risks

(07-06) 04:33 PDT -- Despite how attractive cloud computing can sound as an outsourcing option, there's widespread concern that it presents a security and legal minefield for businesses and government. Cloud service providers often cultivate an aura of secrecy about data centers and operations, claiming this stance improves their security even if it leaves everyone else in the dark.

Businesses and industry analysts are getting fed up with this cloud computing version of "don't ask, don't tell," where non-disclosure agreements (NDA) dominate, questions aren't answered, and data center locations and practices are treated like national security secrets. But public cloud service providers argue their penchant for secrecy is appropriate for the cloud model -- and at any rate, everyone's doing it. They often hold out their SAS-70 audit certifications to appease any worry (though some don't have even that)."The business data you store in Google's cloud is safe," said Google product marketing manager Adam Swidler at the recent Gartner security conference held in National Harbor, Md. He emphasized that Google's multi-tenant distributed model entails "splicing data across many hard drives" so that in this "hardened Linux stack" there's a "quick update of all fragments of all files in the hard drives," a process he called "obfuscated files."

Swidler acknowledged there has been some secrecy about where things are located because "we think it's a security risk." Nonetheless, "Google is trying to open up a little transparency in what we do," he said.

-----

Not satisfied with all this in recent times we have had all the fruits of the NEHTA sponsorship of the RACGP with announcements on such areas as:

Mental Health:

http://aushealthit.blogspot.com/2010/04/more-magical-thinking-from-racgp-on.html

to say nothing of RACGP involvement in Medisecure and all the paid enthusiastic spruiking of the Health Identifiers.

There must be a very keen business development person at the College casting around for e-Health press release opportunities!

Read more on this here:

http://aushealthit.blogspot.com/2010/04/it-seems-someone-is-running-e-health.html

and here:

http://aushealthit.blogspot.com/2010/01/nehta-spin-machine-pops-gasket-and.html

Additionally we have had announcements from the Commonwealth Government about Patient Controlled EHR and an implementation plan that makes little if any sense. See here:

http://aushealthit.blogspot.com/2010/07/we-have-utter-madness-afoot-at-doha.html

In the background we still have only patchy progress on e-prescribing with Standards as yet un-delivered and un-adopted.

Step back for a moment and consider this:

In a presentation in August 2009 Adam Powick of Deloittes, who developed the agreed but still unfunded Nation E-Health Strategy, said on his slide 10 and 11.

Conclusion –the next 12 months are key

•Initial set of national eHealth foundations will be delivered

•Government’s response to reform commission report will be communicated

•Significant eHealth progress planned across all State/Territory jurisdictions and key parts of the private sector

•Beginning of meaningful on the ground collaboration in areas such referrals and discharge summaries

•A number of personal health record solutions will become available to Australian consumers

•Delivery of a national ePrescription capability

Conclusion –the need to work together

We are poised for significant progress but still could easily fragment the national agenda into 1000 moving parts.

What is needed is:

Clarity, Focus, Pragmatism, Leverage, Collaboration.

---- End Slides.

I would add we also need leadership and relevant competent governance. We are not getting any of this and Adam’s prediction get closer by the day I fear. I would also note a lot of what Adam thought would happen has not actually happened yet.

There is a lot of un-coordinated Brownian Motion happening right now and the risk it will all implode and waste heaps of money rises daily!

David.

AusHealthIT Poll Number 26 – Results – 12 July, 2010.

The question was:

How Satisfied Are You With the Leadership and Governance of Australian E-Health?

Thrilled

- 1 (3%)

Pretty Much

- 4 (12%)

Just Above 50%

- 2 (6%)

Not Satisfied

- 7 (21%)

Extremely Unhappy

- 18 (56%)

Votes: 34

This is hardly unexpected. 77% are not impressed. DoHA and NEHTA should take notice!

Again, many thanks to all those who voted

David.

Sunday, July 11, 2010

Weekly Australian Health IT Links – 11 July, 2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or payment.

General Comment:

Well it seems the clearing of the decks before the election is well and truly underway! We have a time-table for health reform, a cancelling of the internet filter for now and lots of NBN activity – to say nothing about advertising for an e-Health CIO for the Department of Health.

The pace of all this – in the middle of winter – suggests something is really afoot!

For myself all I really would like is to see a coherent plan for e-Health, or the lack of it as an election issue. Dream on I guess!

-----

http://www.smh.com.au/national/fears-health-reform-plans-being-rushed-through-20100708-102bq.html

Fears health reform plans being rushed through

MARK METHERELL

July 9, 2010

The federal government's release of a detailed plan to deliver health reform has triggered criticism from health groups that the complex changes are in danger of being rushed through with little input from consumers.

The Australian Healthcare and Hospitals Association, which has supported the reforms, has voiced concern that the reform time frames might be ''unrealistic'' and said it was disappointed at the lack of consultation with consumers.

The association's chief executive, Prue Power, said the most critical element in implementing the new structure of local hospital networks and Medicare locals, and one which had not yet been detailed in the plan, was the integration of patient care between the community and hospital sectors.

-----

http://www.theaustralian.com.au/news/nation/reforms-rushed-says-australian-healthcare-and-hospitals-association/story-e6frg6nf-1225889560692

Reforms rushed, says Australian Healthcare and Hospitals Association

  • Adam Cresswell, Health editor
  • From: The Australian
  • July 09, 2010 12:00AM

THE peak body for Australia's public hospitals has criticised the planned rollout of the federal government's health reforms.

And the Australian Healthcare and Hospitals Association has warned that some measures risk being introduced too fast while also criticising the transparency of the process.

A day after federal Health Minister Nicola Roxon released a detailed timeframe for implementing its reform program, the AHHA said some of the timeframes appeared "unrealistic", particularly for measures that depended on new systems for collecting information.

The AHHA said while it welcomed the document for making "concrete the government's commitment to genuine reform", it was also "disappointed" there was neither a formal mechanism to guide consultations, nor one to include consumer groups in the process. The lack of a formal evaluation plan for the changes also meant Australians "will not know whether or not the reforms have achieved their stated objectives", the AHHA said.

-----

http://www.medicalobserver.com.au/news/expert-claims-reform-think-tanks-biased

Expert claims reform think tanks biased

9th Jul 2010

Andrew Bracey

ATTEMPTS by the Federal Government to overhaul the health system were flawed from the start, a health policy expert has argued, as the independent think tanks steering reform directions were loaded with industry figures unable to “think outside the box”.

Speaking at a health reform forum hosted by the Australian National University last week, Ian McAuley, a fellow of the Centre for Policy Development, said the Government’s advisory bodies, including the National Health and Hospitals Reform Commission, had too much representation by health industry insiders.

The bodies had failed to deliver a blueprint for a better integrated system, he said. Policies such as the controversial diabetes funding scheme focused on “coordinating existing disparate programs rather than re-designing programs themselves”.

-----

http://bayside-leader.whereilive.com.au/news/story/it-system-diagnosis-questioned/

IT system diagnosis questioned

SANDRINGHAM Hospital will get a controversial patient records system upgrade early next year.

The Cerner IT project, in place at the Alfred hospital since March, will be rolled out to Sandringham by early next year.

But the upgraded system, which records patients’ medical history, has been blasted by doctors.

-----

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr140.htm

Release of Roadmap to Reform

7 July 2010

The timeline for the further delivery of better health and hospital services was today released by the Minister for Health and Ageing.

The Government’s ambitious plan to reform our health system is a complex and extensive task, particularly after so many years of neglect under the former Government. It is vital that the implementation of these extensive reforms is carefully planned and well-executed.

The Government’s implementation plan spells out the details as to when initiatives such as extra sub-acute beds, more doctors and more nurses will be part of our health system. It has clear, defined goals for improving the system to which the Government expects to be held accountable.

The plan is carefully structured to ensure that the planned improvements to our health system are delivered to provide better, more connected services for all hard working Australians.

-----

http://www.nehta.gov.au/media-centre/nehta-news/661-youth

Youth lead the adoption of e-health

The ‘net’ generation, spanning 13 to 33 year olds, has embraced technology as the norm and is expected to adopt e-health as just par for the course in their highly connected lives according to several leading youth health experts.

Jonathan Nicholas, Chief Executive Officer of the Inspire Foundation, the organisation behind the web-based mental health support service for young people, ReachOut.com said, “As an organisation that uses the internet to connect with young people, we see a number of benefits for young people flowing from the proposed e-health record.

“They have grown up archiving their life on social networking sites such as Facebook, so saving personal data into web environments is neither alien, nor something they fear. To the contrary, they expect to be able to access their information when they need it, and save it into a secure, centralised location.”

-----

http://www.zdnet.com.au/timetable-confirms-2012-e-health-date-339304399.htm

Timetable confirms 2012 e-health date

By Josh Taylor, ZDNet.com.au on July 8th, 2010

in brief The Federal Government has formally laid out a two-year timetable for delivering e-health to all Australians.

In a statement released yesterday, Health Minister Nicola Roxon outlined the government's "roadmap to reform" in health over the next two years, including the government's plans for an e-health portal. Roxon had previously indicated that she expected the delivery of the online portal that would allow patients access to their e-health records to take around two years, but in her statement yesterday she set a more exact deadline of July 2012.

-----

http://www.computerworld.com.au/article/352600/telstra_gps_e-health_agreement/?eid=-255

Telstra, GPs in e-health agreement

Telstra plays a card in the e-health game, signs MOU with the Royal Australian College of General Practitioners

  • AAP (Computerworld)
  • 09 July, 2010 07:49

The nation's GPs and Telstra have reached an agreement on the roll-out of "critical first step" e-health reforms.

The Royal Australian College of General Practitioners (RACGP) has signed a memorandum of understanding with the telco giant, outlining a range of hi-tech services to be brought online from next year.

The first would allow the nation's 17,200 GPs to access health care applications, diagnostic tools and an array of other clinical and administrative software programs using a "single log-on" web service.

-----

http://www.zdnet.com.au/act-hospitals-buy-intensive-care-system-339304385.htm

ACT hospitals buy intensive care system

By Colin Ho, ZDNet.com.au on July 8th, 2010

Intensive Care Units (ICUs) at Canberra Hospital and Calvary Public Hospital in the Australian Capital Territory will be adopting a new, $1.7 million digital information management system following an announcement yesterday by ACT Health Minister Katy Gallagher.

Delivered by Vision Software Solutions, the information management system will enable paperless management of patient records in the ICUs.

-----

http://www.computerworld.com.au/article/352643/victorian_ict_industry_successes_awarded_by_aiia/

Victorian ICT industry successes awarded by AIIA

AIIA CEO, Ian Birks, sees government engagement as key to Victoria excellence in IT

Government engagement has been key to the success of the ICT industry in Victoria of late, according to Australian Information Industry Association (AIIA) chief executive officer, Ian Birks, but other states are catching up.

Speaking to Computerworld Australia, Birks, said the thriving industry in Victoria could be attributed to financial and innovation input from the State Government.

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eHealth

  • iCare Solutions Pty Ltd. iCare Solutions Aged Care electronic health record – winner
  • Saeid Nahavandi – Multi-Point Haptics for Next-Generation Medical Procedures and Training – merit

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http://www.cio.com.au/article/352367/isoft_claims_healthsmart_win/?eid=-601

iSOFT claims HealthSMART win

E-health giant shrugs off troubles to complete Victorian healthcare project

iSOFT announced it had completed the rollout of new patient management systems in mid-June to Victorian hospitals under Victoria's delayed HealthSMART project begun back in 2003, as financial problems continue to plague the Australian e-health giant.

The overall HealthSMART project was initiated under the Bracks Labor government back in 2003 with a pricetag of $323 million and a due date of 2007. It has since had another $37 million pumped into it, with the due date gradually extending — several years ago it was slated to be finished in 2009.

The iSOFT implementation reflects one substantial chunk of the project — other vendors involved include US-based Cerner and InterSystems subsidiary TrakHealth. iSOFT won an open tender for its portion in December 2005.

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http://abnnewswire.net/press/en/63242/iSOFT_Group_Limited_%28ASX:ISF%29_Secures_A30_Million_Equity_Line_Of_Credit_Facility_With_YA_Global.html

iSOFT Group Limited (ASX:ISF) Secures A$30 Million Equity Line Of Credit Facility With YA Global

Sydney, July 7, 2010 (ABN Newswire) - iSOFT Group Limited (ASX:ISF) today announces that it has secured a A$30 million equity line of credit facility with US-Based Investment Fund YA Global Master SPV Ltd (YA Global).

iSOFT secured the facility in order to provide flexibility in cash management. It will initially be used to replenish cash balances drawn down to fund acquisitions and other capital investments undertaken during the 2010 financial year.

Under the terms of the facility, iSOFT may, at its discretion, issue shares to YA Global at any time over the next 60 months, up to a total of A$30 million. iSOFT may draw down these in tranches of up to A$2.5 million, although this may be varied by agreement with YA Global.

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http://www.e-health-insider.com/news/6062/three_more_lorenzos_by_autumn

Three more Lorenzos by autumn

08 Jul 2010

Three more trusts will go-live with Lorenzo Regional Care Release 1.9 over late summer and early autumn, the Department of Health has told E-Health Insider.

The early adopter sites - Birmingham Women’s NHS Foundation Trust, Pennine Care NHS Foundation Trust and Kettering General Hospital NHS Foundation Trust - have all had significant delays to their go-live dates, after waiting for University Hospitals of Morecambe Bay NHS Trust to go live earlier this year.

A spokesperson for the DH said: “The Department of Health understands these three early adopter trusts are planning to deploy Lorenzo Release 1.9 over late summer and early autumn.

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http://www.theaustralian.com.au/business/health-firm-secures-30m-credit-facility/story-e6frg8zx-1225889571771

Health firm secures $30m credit facility

LIFE isn't getting any easier for iSOFT, but that could be exactly what potential suitors are hoping for.

Within weeks of chief executive Gary Cohen copping a few embarrassing margin calls, the health IT outfit this week unveiled a strange-looking $30 million credit facility with little-known US investment fund YA Global Master. iSOFT plans to use the credit to replenish cash used to fund acquisitions and can pay back the borrowing over the next five years through equity issues. YA will probably get a good price too, with iSOFT yesterday clarifying it would issue shares via a generous formula. iSOFT shares have plunged about 75 per cent so far this year after some disappointing first-half results and fears of a poor full year. There are murmurs of Primary Healthcare and private equity sizing up the group.

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http://press-releases.techwhack.com/56887-isoft-9

iSOFT wins A$1m electronic health record deal with India’s AMRI

Sydney – 7 July 2010 – A $1 million contract with Advanced Medicare Research Institute (AMRI) Hospitals for an electronic health record (EHR) for six of its hospitals in India has been won by iSOFT, after a competitive tender.

Replacing an outdated hospital information system, iSOFT’s Enterprise Management gives AMRI a single, integrated EHR and 700 concurrent users ready access to patient and clinical information to improve efficiency and the quality of care.

The solution is being installed at three hospitals now and three more that have yet to be identified by AMRI. The three hospitals are at Mukundapur, Salt Lake, and Dhakuria, in the state of West Bengal.

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http://www.theaustralian.com.au/australian-it/states-health-payroll-change-was-adopted-untested/story-e6frgakx-1225888223958

Queensland health payroll not fully tested

QUEENSLAND Health had a back-up plan but it failed when its botched payroll and human resources system went live in March, a damning report finds.

The failure left thousands of workers with little or no pay.

Warnings by SAP, IBM and others to properly test the system were not heeded because it was considered too great a task. From the outset, Health, as the main user of the new payroll system, was not kept in the loop, reported Queensland Auditor-General Glenn Poole.

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http://www.couriermail.com.au/news/queensland-health-pay-woes-may-affect-public-service/story-e6freon6-1225888541480

Queensland Health pay woes may affect public service

THE same systemic problems that led to the full-scale Queensland Health payroll debacle pose a risk to many more state government financial transactions including payment of thousands of public servants across a range of departments.

A damning report by Auditor-General Glenn Poole has found that financial disaster resilience – the ability to continue paying people in the face of a complete system failure – is lacking across the Government with insufficient safety nets in place over all three shared service agencies.

This means that thousands of public servants employed by the Government are potentially exposed to a crisis like the QH payroll.

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http://www.theaustralian.com.au/news/nation/auditor-general-glenn-poole-warns-payroll-disease-may-spread/story-e6frg6nf-1225888699745

Auditor-General Glenn Poole warns payroll disease may spread

PAYROLL blunders like the one in which Queensland Health workers were underpaid for months may spread in the state's public sector.

In his annual report, the Auditor-General Glenn Poole also criticised the government for allowing contractors to complete paperwork out of sequence and inadequately safeguarding against conflicts of interest. The report noted some systems used by CorpTech, the government's corporate IT agency, were due to become unsupported by 2013. There was therefore a "critical" need to consolidate CorpTech's systems, the report said.

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http://www.misaustralia.com/viewer.aspx?EDP://1278457812802&section=news&xmlSource=/news/feed.xml&title=Qld+AG+releases+second+damning+payroll+report

Qld AG releases second damning payroll report

The Queensland Auditor General has released another damning report warning the state government is at risk of financial security failures that could result in a further payroll debacle.

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http://www.couriermail.com.au/lifestyle/experts-cool-on-thermal-imaging-for-breast-cancer/story-e6frer4f-1225888270813

Experts cool on thermal imaging for breast cancer

HEALTH authorities are warning women about thermal imaging clinics offering breast-cancer screening, saying free mammograms are more effective in detecting tumours at an early stage.

The emergence of thermography clinics has Queensland Health, the Cancer Council Queensland and the Royal Australasian College of Surgeons concerned.

Brisbane breast surgeon Ian Bennett said thermography was a primitive form of imaging not much better for detecting breast cancer than self-examination.

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http://www.smh.com.au/technology/security/online-id-fraud-losses-explode-to-13bn-a-year-20100705-zxbj.html

Online ID fraud losses explode to $1.3bn a year

ASHER MOSES

July 6, 2010 - 7:00AM

One in 10 Australian internet users have lost money to online identify fraud over the past year with losses totalling $1.286 billion, according to the VeriSign Online Fraud Barometer figures released today.

The findings represent a significant increase on the figures reported in June by the Australian Bureau of Statistics, which surveyed Australians in 2007 and found that just over 800,000 had been victims of personal fraud. Back then, combined losses were $977 million.

VeriSign's figures suggest 1.37 million Australians, or 10 per cent of internet users, have fallen victim to online fraud in the past year. The results are based on a survey of 2510 Australians aged 18 years and over conducted in June this year by Galaxy Research.

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http://www.computerworld.com.au/article/352086/nbn_could_opt-out_tasmania_premier/?eid=-6787

NBN could be opt-out in Tasmania: Premier

Tasmanian Premier, David Bartlett, told a Senate estimates hearing that an opt-out model is feasible for the NBN

Tasmanian State Premier David Bartlett has committed to ask the Tasmanian NBN Company whether it would be feasible for Tasmanians to be required to opt-out from having the planned optic fibre cables connected to their premises -- reversing the current policy where they are required to opt-in.

"When I next meet with Doug Campbell, the chair of TNBN Co, I am happy to raise it with him and ascertain whether it has been considered," Bartlett said in a parliamentary estimates committee last week in response to questions on the matter from opposition MP Michael Ferguson.

"I do not think it is the Government's to consider; effectively it is TNBN Co's to consider ... I think your logic in simplistic terms sounds reasonable but I would not know what various legislative or other regulatory impacts on that logic there might be. It might be that governments do not have the power to just connect anything to any house and if you do not like it you had better have opted out," Bartlett added.

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http://www.smh.com.au/technology/technology-news/22-questions-you-need-answered-on-the-national-broadband-network-20100703-zufy.html

22 questions you need answered on the national broadband network

July 3, 2010

When it comes to internet, it's all about connections, writes David Humphries.

1. How does NBN differ from my existing internet connection? Current internet connections are based on copper networks, which do not have sufficient capacity for video services. The network will operate mainly on optical fibre, a thin glass or plastic strand that carries light from lasers shone down the fibre and detected by receivers at the other end.

2. Why change to an NBN connection? Quality in relation to security, privacy, reliability and speed, the advantages are most noticeable with video services. The network will be be 50 to 100 times faster.

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http://www.news.com.au/breaking-news/nbn-to-be-the-gateway-to-better-services/story-e6frfku0-1225887791300

NBN to be the 'gateway to better services'

  • From: AAP
  • July 05, 2010 12:17AM

FAST broadband will improve health, education and the environment, a national think tank will hear in Brisbane today.

Terry Cutler, chair of the ATC Centre of Excellence for Creative Industries and Innovation, said attention should shift from infrastructure to public benefits now that a deal had been struck with Telstra on the rollout of the National Broadband Network (NBN).

On June 20, after protracted talks between the government and Telstra, an $11 billion deal was struck for Australia's biggest telco to lease its infrastructure to NBN Co, the company that will build and run the network.

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http://www.theaustralian.com.au/australian-it/labor-ups-nbn-trial-sites/story-e6frgakx-1225889317373

Labor ups NBN trial sites

THE Gillard government has rushed ahead with its NBN plans even though the project will be cancelled if it loses the next election.

Communications Minister Senator Stephen Conroy yesterday announced that the government would soon unveil at least 20 more mainland NBN construction sites.

"It's full steam ahead with the NBN. We recently announced the agreement with Telstra, and we're very close to announcing the next 20 or so mainland sites where we will be connecting and the trucks will start rolling,'' Senator Conroy said.

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http://www.theaustralian.com.au/business/national-broadband-network-cost-could-balloon-says-chief/story-e6frg8zx-1225890003753

National broadband network cost could balloon. says chief

THE cost of funding the national broadband network construction is unknown and could balloon NBN Co chief executive Mike Quigley says.

The man in charge of the federal government's nascent national broadband network said the "nation-building project" was potentially a bottomless pit when it came to funding and he had no idea what the cost would ultimately be.

"When it comes to cost you always have to ask at what point do you stop? It's a very long-term project -- money will be out into this network for years and years and years, as it is upgraded," Mr Quigley said.

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http://www.smh.com.au/technology/technology-news/gillard-to-stick-with-web-filter-despite-disquiet-20100707-100qe.html

Gillard to stick with web filter despite disquiet

ARI SHARP COMMUNICATIONS CORRESPONDENT

July 8, 2010

THE Prime Minister will push ahead with controversial plans for a mandatory internet filter despite acknowledging public concerns that it will interfere with ''legitimate use''.

In Julia Gillard's first comments on the filter since becoming Prime Minister, she told ABC radio in Darwin that the proposal was an effort to control the ''dark side'' of communications technology.

''Images of child abuse, child pornography - they are not legal in our cinemas,'' she said yesterday. ''Why should you be able to see them on the internet? I think that that's the kind of moral, ethical question at the heart of this.''

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http://www.theaustralian.com.au/australian-it/filtering-legislation-on-the-way/story-e6frgakx-1225889109550

ISP filtering legislation on the way

  • Fran Foo and Andrew Colley
  • From: Australian IT
  • July 07, 2010 6:30PM

THE federal government hopes to introduce legislation to enable its controversial internet filter by the end of the year.

Communications Minister Stephen Conroy said the legislation would be this year "sooner rather than later''.

Timing for the web filter legislation, which has earned the ire of ISPs and internet freedom advocates, depends on the date for the looming federal election and whether Labor wins office.

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http://www.theage.com.au/technology/technology-news/internet-filter-wont-protect-kids-20100708-102ap.html

Internet filter 'won't protect kids'

ARI SHARP

July 9, 2010

PROTECTING children online could be harder with a mandatory internet filter in place, a coalition including state schools, librarians and key players in the internet industry has warned.

The recently formed Safer Internet Group argues that the federal government's proposed filter is a simplistic solution to shielding children from harmful content on the internet.

''We believe that real online safety can be delivered without the implementation of a mandatory internet filter, which locks parents and the industry out of keeping kids safe online,'' the group wrote in a submission to a parliamentary committee on cyber safety.

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http://www.computerworld.com.au/article/352649/filtered_internet_70_web_users_under_government_deal/?eid=-6787

Filtered Internet for 70% of web users under government deal

National Internet content filtering delayed for a year

Up to 70 per cent of Australians will have filtered Internet access under a deal between Telstra, Optus, iPrimus and the Federal Government, Communications Minster Stephen Conroy said today.

Under the deal, the Internet Service Providers (ISPs) will impose web content filtering for their customers and in turn the Federal Government will postpone its national mandatory Internet content filtering scheme for a year.

The Federal Attorney-General‘s office will also review the filter blacklist - or refused classification content - to be administered by the Australian Communications and Media Authority (ACMA).

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http://www.theage.com.au/national/gillard-dodges-flak-on-filter-20100709-1046r.html

Gillard dodges flak on filter

DAN HARRISON

July 10, 2010

AS JULIA Gillard clears the decks for an election that could be called as soon as next weekend, she has moved to limit the political fallout from Labor’s controversial plans to filter internet pages by putting the proposals off indefinitely.

The politically motivated deferral — which the opposition immediately branded a ‘‘humiliating backdown’’ — follows other recent policy reversals, softenings and adjustments as the government rushes to allay the concerns of various constituencies before the poll.

The latest U-turn is Ms Gillard’s new asylum policy, embracing offshore processing.
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Enjoy!

David.